Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

HealthPayerIntelligence News

CMS Mulls End of Auto-Reenrollment, Silver Loading in ACA Market

by

CMS has issued its proposed Payment Notice for the 2020 plan year, which contains provisions that would significantly alter the operations and structure of the ACA individual marketplace. Continuing a pattern of using CMS regulatory...

Payer Investment May Improve Delaware Primary Care Access

by

Payers can expand primary care access in Delaware by progressively increasing primary care spending until it accounts for 12 percent of all healthcare investment, according to a report from Delaware’s Primary Care...

Blue Cross of NC, Major Health Systems Partner for Value-Based Care

by

Blue Cross and Blue Shield of North Carolina has launched Blue Premier, a new value-based care model that increases accountability for participating providers and their accountable care organizations (ACOs). Beginning in January of 2019,...

Apple Floats Idea of Subsidizing Watches for Medicare Advantage

by

Apple has approached several Medicare Advantage plan providers to discuss the idea of subsidizing its Apple Watch for at-risk seniors, according to industry reports. CNBC reporter Christina Farr states that at least three Medicare...

HCTTF Offers Clinical Episode Grouper Resources for Bundled Payments

by

The Health Care Transformation Task Force (HCTTF) has released a new set of resources to support payers as they develop innovative bundled payment programs. In a white paper titled Episode Groupers: Key Considerations for Implementing...

After Buying Aetna, CVS Health Commits $100M to Address SDOHs

by

With its $69 billion acquisition of Aetna in the books, the newly expanded CVS Health is now investing heavily in developing and deploying new models to address community wellness and the social determinants of health (SDOH). The...

Anthem Medicare Advantage Members Can Use OTC Allowance at CVS

by

Anthem Blue Cross (Anthem) Medicare Advantage members in California will now be allowed to purchase over-the-counter products at CVS Pharmacy stores using their health plan allowance. The partnership, launched on January 1, is intended to...

NYC Mayor Announces Plan to Guarantee Health Coverage for All Residents

by

Mayor Bill de Blasio has announced the launch of a comprehensive, universal healthcare coverage plan that will guarantee benefits for every New Yorker. “Healthcare is a right, not a privilege reserved for those who can afford...

Change Healthcare, Health Fidelity Apply AI to Risk Adjustment

by

Change Healthcare and Health Fidelity have announced a collaboration to offer AI-driven risk adjustment coding solutions for Medicare Advantage, ACA commercial, and Medicaid payers. The tool leverages natural language processing (NLP) and...

Government Shutdown Spares Medicare, Medicaid, But Has Other Impacts

by

The partial government shutdown will have no impact on Medicare and Medicaid at the federal level, CMS has stressed to industry observers. The nation’s public payers will continue to operate as normal, since funding for CMS is...

Patient-Centered Methods Help Health Plans Boost Cancer Care

by

Employers and payers should ensure their health plans use patient-centered methods and provider performance measurement strategies to reduce costs and improve cancer care, a report from the National Alliance of Healthcare Purchaser...

Verma: Price Transparency Rule a “First Step” for Consumerism

by

The hospital price transparency mandate that went into effect on January 1 is still ruffling feathers among healthcare providers, leading CMS Administrator Seema Verma to reiterate the importance of giving consumers access to pricing...

CA Governor Addresses Prescription Drug Costs, Healthcare Access

by

California Governor Gavin Newsom has announced a series of major executive actions and budget proposals to reduce prescription drug costs and move California closer to the goal of healthcare coverage for all. Newsom’s healthcare...

60% of Medicare Advantage Members Feel Little Motivation from Plans

by

Medicare Advantage (MA) plans are not doing enough to motivate their members to improve their personal health, according to a new survey from HealthMine. Sixty percent of members participating in the poll said that their MA plans do not...

Steward Health Care Joins Mission to Expand Generic Drug Access

by

Steward Health Care has become a founding member of Civica Rx, a collaborative, non-profit drug company with the mission to reduce drug costs and increase the supply of life-saving generic medicines. Approximately 800 US hospitals have...

Nearly 50% of Pre-Medicare Adults Worried About Healthcare Costs

by

Forty-five percent of adults aged 50 to 64 are not confident that they will be able to afford healthcare coverage in retirement, according to a poll conducted by the University of Michigan Institute for Healthcare Policy and Innovation and...

AHIP Urges “Careful Planning” of Health Reimbursement Arrangements

by

AHIP is cautioning federal regulators to move slowly and carefully when expanding the availability of health reimbursement arrangements (HRAs) as a more prominent means of paying for healthcare services. In response to a request for...

DOJ Recovers $2.5B in Healthcare Fraud, False Claims in 2018

by

2018 was a bad year to be a healthcare fraudster.  The Department of Justice (DOJ) has announced that $2.5 billion of the total $2.8 billion recovered under the False Claims Act can be attributed to fraud and improper claims from...

CVS Health to Begin Important Work of Integrating Aetna

by

On the eve of Christmas, Judge Richard Leon of the United States District Court for the District of Columbia decided against halting the integration of the two companies in a merger valued at $69 billion. “Based on CVS’s...

Hospital Price Transparency Rule Takes Effect January 1, 2019

by

Starting January 1, 2019, hospitals will be required to post their price lists online in an effort to increase price transparency and empower consumers to make informed choices about their care. The mandate stems from the 2019 inpatient...

X

Sign up for our free newsletter:

Our privacy policy


no, thanks

Continue to site...